Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology (Topic C) > C4. Antifungal agents > Flashcards

C4. Antifungal agents Flashcards

1
Q

What is the MOA of Amphotericin B?

A

Binds ergosterol and forms pores in fungal cell membrane.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the indications for caspofungin?

A
  1. Invasive aspergillosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the side effects of Anidulafungin?

A
  1. May cause HA release on infusion → flushing.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the side effects of micafungin?

A
  1. Increases risk of hepatic cancer
  2. Suppresses bone marrow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the MOA of Flucytosine?

A

converted into 5-fluorouracil → halts DNA/RNA synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the SE of Flucytosine?

A
  1. Bone marrow suppression
  2. Hepatotoxicity
  3. May cause toxic enterocolitis at high doses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the MOA of Nystatin?

A

Same as amphotericin, binds ergosterol and forms pores in fungal cell membrane.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the MOA of Azoles?

A

Azoles inhibit ergosterol synthesis from lanosterol via fungal CYP450 (14-alpha demethylase).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List the First Generation Triazoles?

A
  1. Fluconazole
  2. Itraconazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the indications for Itraconazole?

A
  1. Good for dimorphic fungi (Histo, Blasto, Coccidio, Sporothrix) and for onychomycosis and dermatophytosis (tinea) … remember T drugs for tinea (Keto-/Clotrim-/Itraconazole, Terbinafine)
  2. Also effective in Aspergillus infections.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the indications for Fluconazole?

A
  1. Mucocutaneous Candidiasis (1x oral dose for vaginal candidiasis, IV for esophagitis)
  2. Cryptococcal meningitis (treatment and prophylaxis)
  3. Sepsis in ICU
  4. Skin and nails infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List the second generation of triazoles.

A
  1. Ketoconazole
  2. Clotrimazole
  3. Imidazoles
  4. Posaconazole
  5. Voriconazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the indications for Ketoconazole?

A
  1. For topical use in dermatophytos
  2. Can help in Cushing’s to ↓ cortisol production…due to the androgen/estrogen synthesis inhibition.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the indications for Clotrimazole?

A

Good for dermatophytosis and vaginal candidiasis topically.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is important to remember about the imidazoles?

A

That they are not used systemically.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the indications of Posaconazole?

A

Posaconazole is a triazole antifungal drug that is used to treat invasive infections by Candida species and Aspergillus species in severely immunocompromised patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the indications of Voriconazole?

A
  1. Invasive Aspergillosis
  2. Candida esophagitis (in AIDS patients)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What spectrum does Amphotericin B cover?

A
  1. Broadest anti-fungal used for severe systemic fungal infections:
    • Histo
    • Coccidio
    • Blasto
    • Crypto meningitis (with flucytosine)
    • Systemic candidiasis
    • Works for all fungi except dermatophytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the side effects of Amphotericin B?

A

Mostly by non-specific cholesterol binding

  1. Immediate: infusion-related; fever, chill, spasm, vomiting, headache + hypotension
  2. Slower: renal damage (tubular injury, T1RTA → hypokalemia, azotemia, Mg wasting); anemia (via ↓ EPO) can give IV saline to minimize ↓ GFR and renal damage
  3. Thrombophlebitis at injection site
  4. Seizures and neuro damage if intrathecal
20
Q

List the other anti-fungals:

A
  1. Echinocandins
  2. Terbinafine
  3. Griseofulvin
21
Q

What is the MOA of Echinocandins?

A

Echinocandins inhibit synthesis of polysaccharide glucan in synthesis of cell wall (not the membrane!)

22
Q

What are the indications of Terbinafine?

A
  1. Used topically for dermatophytosis (first-line for tinea capitis in kids)
  2. Used orally for onychomycosis (also deposits in keratin tissues)
23
Q

What are the indications of Griseofulvin?

A

It accumulates in keratin-producing tissues given orally for dermatophytosis; long-term for onychomycosis.

24
Q

What spectrum does nystatin cover?

A

Most Candida species

25
Q

What are the side effects of Azoles?

A
  1. Interactions - via CYP450 inhibition
26
Q

List the antifungal treatment options.

A
  1. Antibiotics
  2. Antimetabolites
  3. Azoles
  4. Allylamines
  5. Echinocandins
27
Q

List the Echinocandins.

A
  1. Caspofungin
  2. Anidulafungin
  3. Micafungin
28
Q

List the Allylamines.

A
  1. Terbinafine
  2. Naftitine
29
Q

List the azoles.

A
  1. Imidazoles: Ketoconazole, Clotrimazole, Oxiconazole, Miconazole.
  2. Triazoles: Fluconazole, Itraconazole, Voriconazole, Posaconazole.
30
Q

List the antimetabolites.

A
  1. Flucytosine
31
Q

List the antibiotics.

A
  1. Polyene: Amphotericin B, Nystatin
  2. Heterocyclic benzofuran: Griseofulvin
32
Q

What are the indications of Flucytosine therapy?

A

Often given in combo with amphotericin for Cryptococcal meningitis combination causes ↑ 5-FC entry, ↓ toxicity + therapy duration, and ↓ resistance.

33
Q

Does Itraconazole penetrate the CNS?

A

It has poor CNS entry.

34
Q

Can Fluconazole penetrate the CNS?

A

Yes, it penetrates CNS well.

35
Q

What is the route of administration of Ketoconazole?

A

ONLY used locally, is not given systemically, because has worse CYP450 and androgen/estrogen synthesis inhibition (→ gynecomastia, oligospermia, impotence).

36
Q

List the Imidazoles.

A
  1. Clotrimazole
  2. Ketoconazole
37
Q

What interaction can Voriconazoles have?

A

Particularly strong CYP450 inhibitor.

38
Q

What are the side effects of Voriconazoles?

A

It can cause visual disturbances - light flashes, ↓ color vision.

39
Q

What is the route of administration of Echinocandins?

A

It is given IV

40
Q

What are the indications of Echinocandins?

A

Highly effective for systemic Candida (mucocutaneous, esophageal and candidemia).

41
Q

How are the pharmacokinetic parameters of Amphotericin B?

A
  1. IV admin only
  2. Liposomal form exists → ↓ cholesterol binding → ↓ toxicity.
  3. Intrathecal admin for CNS fungal infections.
  4. Often combined with flucytosine for cryptococcal infection.
42
Q

What are the side effects of Echinocandins?

A
  1. well tolerated
  2. minor GI effects + flushing
43
Q

What is the MOA of Terbinafine?

A

Terbinafine interferes with ergosterol synthesis via squalene epoxidase inhibition → accumulation of toxic squalene → fungicidal effect.

44
Q

What are the side effects of Terbinafine?

A
  1. GI effects
  2. Hepatotoxicity
45
Q

What is the MOA of Giseofulvin?

A

Giseofulvin binds to fungal microtubules → halts mitosis, acting as a fungistatic.

46
Q

What is the route of administration of Nystatin?

A

Available topically or as a rinse (oral candidiasis); not given systemically.

47
Q

What are the side effects of Griseofulvin?

A
  1. GI symptoms
  2. Headache
  3. Rash
  4. Hepatotoxicity
  5. Granulocytopenia
  6. Induces CYP450 enzymes

Pharmacology (Topic C) (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions